Hand Hygiene Hands of the HCWs are the main source of transmission of infections in healthcare facilities. Hand hygiene is therefore the most important measure to avoid the transmission of harmful microbes and prevent healthcare-associated infections. >>Types of Hand Hygiene Methods Hand Rub Alcohol based (70-80% ethyl alcohol) and chlorhexidine (0.5-4%) based hand rubs are available. The duration of contact has to be at least for 20-30 seconds. © ™ Advantage: After a period of contact, it gets evaporated of its own, hence drying of hands is not required separately ™ Indications: Hand rub is indicated during routine patient care activities or taking rounds in the wards or |CUs—whenever opportunity for hand hygiene arises, except when the hands are visibly soiled with blood or other specimens. _ Hand Wash Antimicrobial soaps (liquid, gel or bars) are availablecontaining 4% chlorhexidine. The duration of contact has to be at least for 40-60 — seconds. Hand washing is indicated in the following situations: ™ When the hands are visibly soiled with blood, excreta, pus, etc. ™ Before and after eating ™ After going to toilet ™ Before and after shift of the duty ™ When giving care to a patient with diarrhea. Surgical Hand Scrub (3-5 min): This is indicated prior to any surgical procedure and also in between the cases; using 4% chlorhexidine hand wash. After touching a patient,Palm to palm Back to palm (both sides) SE SO Back of finger on palms Interlaces (in between web space) (Rotational a both sides) (both the sides) —— your nails on plams (both sides) Personal Protective Equipment (PPE)Personal protective equipment are used to protect the skin and mucous membranes of HCWs from exposure to blood and/or body fluids and from the HCW to the patient during sterile and invasive procedures. Personal protective equipn B. heavy duty gloves; c. ‘pron, F Linen gow: 6. 0 4. Face shield, K Cap; L Shoes; M. Gum boot; N. Sho (PPE). A. Gloves; ask; D. N95 Donning and DoffingIn order to minimize the risk of transmission of infection, donning (wearing) and doffing (removing) of PPE must be performed in a particular sequence. Surgical Mask (3-ply Mask) Composition It has three layers 1. Outer fluid repellent layer: Hydrophobic layer that can repel water, blood and body fluids2. Middle filter layer: It is made up of melt-blown material; filters bacteria/viruses and also filters out the water droplets. 3. Inner hydrophilic layer: Absorbs water, sweat and spit; made up of non-woven fabric. Middle layer /_ meltblown filter Respirator (N95 Respirator) Composition: The N95 respirator is comprised of four layers of material: an outer and inner layers of spunbond polypropylene and middle two layers of cellulose/ polyester, melt-blown polypropylene filter a, F-Steps of mask donning (wearing). + Pull the straps tight and pull the mask to below chin and then apply knots. + Press on the nasal bridge part of the mask to seal tightly and for N95 respirator, perform fit check. Steps of mask removal (doffing). + Do not touch front part of the mask. + Untie the lower knot first, then the upper knot and remove the mask by holding its straps, without touching the front; hand wash after removal. t =5(Lots Steps of gloves donning (wearing). 1. Donning of the first glove: Wear by touching and pulling only the edge of the cuff. 2. Donning of the second glove: Avoid touching the forearm skin by pulling external surface of second glove by the finger of gloved hand. Steps of gloves removal (doffing). Do not touch the outside of the gloves (contaminated) + Using a gloved hand, grasp the palm area of the other gloved hand peel off first glove. + Hold removed glove in gloved hand slide fingers of ungloved hand under the other glove at wrist and peel offsecond glove over first glove. + First glove will remain inside the pouch of the second glove. + Perform hand hygiene after removal. Wh